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At least 307 records · Page 17Linked to original sources
PubMed1997

The future of physician practice management companies.

Physician practice management (PPM) companies are growing sector of the healthcare industry and have caught the attention of Wall Street, as evidenced by the number of initial public offerings of PPMs in the past three years. The cost of operating efficiencies, declining premiums, integration, oversupply of specialists, shift from a gatekeeper to a direct-access model, and cultural challenges are the emerging market forces that may affect PPM viability. The challenge for PPMs is to maintain earnings growth in the face of these market forces.

Commerce↗
PubMedDate not supplied

Establishing physician networks within evolving antitrust guidelines.

Rapid changes in health care are being driven by the growth of managed care. Health plans have become more aggressive in negotiating with physicians, and providers have increasingly chosen to establish networks in response. Because these provider networks frequently represent horizontal forms of integration between competitors, antitrust issues have become increasingly important. This article addresses current antitrust law as it relates to physician networks. In particular, it reviews the most recent statements of antitrust enforcement policy of the Department of Justice and the Federal Trade Commission concerning physician networks. Procompetitive activities by physician networks are central to the latest rulings.

Antitrust Laws↗
PubMed1997

The relationship and tensions between vertical integrated delivery systems and horizontal specialty networks.

UNLABELLED: This activity is designated for physicians, medical directors, and healthcare policy makers. GOAL: To clarify the issues involved with the integration of single-specialty networks into vertical integrated healthcare delivery systems. OBJECTIVES: 1. Recognize the advantages that single-specialty networks offer under capitated medical care. 2. Understand the self-interests and tensions involved in integrating these networks into vertical networks of primary care physicians, hospitals, and associated specialists. 3. Understand the rationale of "stacking" horizontal networks within a vertical system.

Community Networks↗
PubMed1997

The three dimensions of managed care pharmacy practice.

Our goal is to provide a framework for pharmacy in an evolving healthcare marketplace by identifying and discussing the three dimensions of pharmacy practice: (1) pharmacy practice across the continuum of care; (2) the major elements of pharmacy practice; and (3) the evolution of pharmacy during the five stages of the development of managed care. The framework was devised under the proposition that there is a substantial consistency in what patients need or should expect from pharmacists. As integrated health systems develop, pharmacists must apply their skills and knowledge across the continuum of care to ensure that they play an integral part in the systems. In a managed care environment characterized by change and the development of integrated health systems, pharmacists have opportunities to become involved directly in patient care in such areas as disease prevention, home healthcare, primary care, and subacute care. Information systems, hospital drug distribution, clinical pharmacy, and the fiscal environment comprise the major elements of pharmacy practice within an integrated health system, and the way in which each of these elements evolves as the healthcare market adapts to managed care is critical to pharmacy practice. If the pharmacy profession can demonstrate its ability to manage disease and health, improve outcomes, and reduce costs within the evolving healthcare system, pharmacists will play a vital role in the managed healthcare market in the approaching new millennium.

Continuity of Patient Care↗
PubMed1991

Biomedical applications of NASA technology.

Through the active transfer of technology, the Technology Utilization (TU) Program of the National Aeronautics and Space Administration (NASA) assists private companies, associations, and government agencies in using NASA's technological resources effectively to improve U.S. economic competitiveness and to provide societal benefit. This article discusses several examples of how aerospace technology has been adapted to solve health care problems.

Aerospace Medicine↗
PubMed1997

Physician practice management companies: implications for hospital-based integrated delivery systems.

Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

Capital Financing↗
PubMedDate not supplied

Assessing the effect of increased managed care on hospitals.

This study uses a new relative risk methodology developed by the author to assess and compare certain performance indicators to determine a hospital's relative degree of financial vulnerability, based on its location, to the effects of increased managed care market penetration. The study also compares nine financial measures to determine whether hospital in states with a high degree of managed-care market penetration experience lower levels of profitability, liquidity, debt service, and overall viability than hospitals in low managed care states. A Managed Care Relative Financial Risk Assessment methodology composed of nine measures of hospital financial and utilization performance is used to develop a high managed care state Composite Index and to determine the Relative Financial Risk and the Overall Risk Ratio for hospitals in a particular state. Additionally, financial performance of hospitals in the five highest managed care states is compared to hospitals in the five lowest states. While data from Colorado and Massachusetts indicates that hospital profitability diminishes as the level of managed care market penetration increases, the overall study results indicate that hospitals in high managed care states demonstrate a better cash position and higher profitability than hospitals in low managed care states. Hospitals in high managed care states are, however, more heavily indebted in relation to equity and have a weaker debt service coverage capacity. Moreover, the overall financial health and viability of hospitals in high managed care states is superior to that of hospitals in low managed care states.

Capitation Fee↗
PubMedDate not supplied

Consumer-centered vs. job-centered health insurance.

Most employees and their dependents in the United States have health insurance provided by the employer or labor-management health and welfare fund. In this system, employees and their families lose their health insurance when the breadwinner loses his or her job while, at the same time, a Medicaid beneficiary can lose Medicaid eligibility by getting a job, even a poorly paid one. Most health insurance pays the doctor on the basis of fee-for-service and the hospital on the basis of cost-reimbursement, rewarding both with more revenue for providing more and more costly services. The insured employee has little or no incentive to seek out a less costly provider. There are no rewards for economy in this system. It should be little wonder, then, that health care costs are out of control. There are alternative financing and delivery systems with built-in incentives to use resources economically, but, the author of this article asserts, their ability to compete and attract patients with their superior economic efficiency is blocked by many laws and government programs. The author believes that the most effective and acceptable way to get costs under control, and at the same time achieve universal coverage, would be through a system of fair economic competition. He discusses his Consumer Choice Health Plan proposal and describes how one of the main barriers to competition is today's system of job-linked health insurance.

Commerce↗